Skylar86

Hey everyone, I work in a busy emergency department. Over the past few months we've been short staffed and over capacity (almost daily). Anyways, I felt unwell with niggling abdominal pain when I woke up this morning but not to the point where I felt I should call in sick (i cant remember the last time i called in sick). About 3 hours into my shift the pain gradually become worse... then severe along with nausea. I took some meds thinking it was gastritis and would settle but it did not. I was in the middle of doing an assessment and had to excuse myself. I went straight to my charge nurse and asked to go home. I was literally in tears and guarding my abdo. Without any change of expression my charge nurse looked at our roster and bluntly said, "we have no one to cover you, unfortunately you're going to have to stay until the end of your shift because its not fair on the rest of the team". Talk about a guilt trip. I felt quite shocked and helpless. I then became stressed and anxious thinking to myself.. how the hell am I am meant to work when I can hardly walk due to the pain. I walked away from my charge nurse (very gingerly) to compose myself and prep myself to go back and finish the assessment. It wasn't until a co-worker asked if I was okay that I burst into tears. My co-worker ended up bringing me into a side room, triaging me and telling our charge nurse that I wasn't able to work. I did not want to be triaged (i have never been a patient in hospital ever before). I felt i could go home,take some good analgesia in fetal position and ride it out until i was able to see my own doctor but I felt I had no choice since i was being made to stay and work. I ended up getting a full work up including IV morphine to settle the pain. I am seeking advice. Do I e-mail the charge nurse manager to express my disappointment with the staffing levels and how that charge nurse handled the situation? I loathe confrontation and I'm not comfortable approaching that particular charge nurse one on one. Or do I need to understand from that charge nurses side... being under pressure with short staff? I sometimes over analyse situations and wonder if it could have been a personal issue with me (I recently reduced my hours to part-time because I got a new job on the side). Lastly, that particular charge nurse is responsible for the roster and has been very flexible with my hours surrounding my new side job and I would hate to cause a stir since she's the one who approves the shift swaps. She's been very good to me with giving me the shifts/hours I want.

I suppose I should have used a different title for this thread. Unnecessary is more the word I was looking for rather than invasive. I realise nothing is going to be distressing for someone who already has a gcs of 3 however the time it would take to put in the IDUC for the patient is time taken away from the family to have with their loved one. Just like the 15min it took for the patient to have the CT. Imagine she had died in the CT room without the family there? I just found it all upsetting.

Hey team, I'm a fairly new nurse who works in a busy adult emerg dept. A few days ago i was working in the acute area (ratio of 1:6). During my shift I had a patient (80F, multiple comorbidities) be transferred from resus to one of my side rooms. She came to ED from a rest home with decreased LOC, GCS 3 on arrival. After assessment from the ED consultant everyone including the family were happy for the DNR decision. The plan was we would be just be providing comfort cares and transfer her to the medical ward once a bed was available. Once she came into my side room it was obvious she didn't have much time left. GCS still 3, HR 120, RR 40- agonal breathing, pale, dry.. etc. The entire family was present.. everyone was saying their final goodbyes. Then comes in the medical registrar. He finds out that theres been a history of abuse from the husband (who doesn't live with the patient and isn't allowed to be alone with her and there hasn't been ANY recent documented abuse). He decides he wants a diagnosis as to why she is dying otherwise he's going to make it a coroners case. He then orders IVABS, a CT head, wants me to go and get OBS and even asks for an in/out IDUC for a urine spec!!! I felt extremely uncomfortable with those orders. The IVABS (although i felt it was pointless I still did it since i could sneak in behind the family and not be in the way) but thought of an invasive procedure (catheter) while this woman is minutes from dying made me SO upset that I literally went completely red, filled up with tears and couldn't speak as i felt i would burst out crying. He then went to my charge nurse and yelled ''i would appreciate if your nurses didn't give me negative attitude whenever I make a decision' (apparently i rolled my eyes as well). My charge nurse could tell by my obvious body language that I was upset so she sent me off the floor to take a few minutes. I left the floor for about 10min to gather myself and get some fresh air. When I came back our transport nurse had taken the patient to CT (NAD found). As soon as they moved her back into the room the patient died. She just got back in time for the family to be with her as she passed. My question is. If she hadn't died.. would I of had to kick the family out to put in an in/out catheter no matter how uncomfortable I was doing that? What would I have done if she had died while I was trying to put a catheter in? Should i be disappointed with myself in how I dealt with this situation (i.e unable to articulate myself when trying to be an advocate for my pt). Was it unprofessional of me to get so emotional and show my personal views?

I am a New Zealand trained RN and have been working in emerg for 3 years. I am currently going through the NNAS process to be eligible to write the NCLEX and have been using Uworld as my study guide. I am hoping to move to Saskatchewan, Canada and work in emerg. So far i haven't been doing great on the practice tests (i have only just started studying) I am wondering how much of the exam will be asking about blood values. This is something that we were never taught in nursing school (i've more just been learning on the job) but its not something we've been required to interpret. Do you recommend I learn all I can about every single blood value in order to pass the NCLEX?

im not sure what your policy includes but in the emergency department that i work at we have ''standing orders''. We can give paracetamol (tylenol), oxygen and normal saline without it being charted... we just need to get it charted/signed at some stage.

wow... skirts/stockings? i cant imagine!!! all of the nurses wear light colored blue scrubs and the doctors wear navy blue scrubs. We have our own change room and are actually not allowed to wear our scrubs out of the department. We are also not allowed to bring them home to wash (infection control). I absolutely love it that way.. it means i never have to do washing!! There's been a few occasions where I've been contaminated with body fluids and have had to change into a new set of scrubs at work... (the odd occasion i've had to have a full shower!) im curious. what do you do if you get dirty at work (i.e blood/vomit?) are there spare shirts/stockings around??

on days off when someone asks you what time it is and instead of looking at your wrist you look at your chest/hip for your fob watch...

you realize that as a patient you have the right to refuse right? why didnt you refuse the ms?

if the OP is a student.....that explains everything!

13y/o boy placed 30 little magnetic balls into his urethra. he was able to pee ("shoot") the first one out and thought that by putting in more he could make his member into a machine gun? Ended up having to tell his mum when he was only able to urinate drops of blood...

Hi everyone. On my last shift I came across an interesting situation. I had a 67y/o man come in with chest pain who spoke very little English (I can't remember exactly where he was from). Long story short, it was very difficult to obtain consent from him to obtain blood. I completely understand the religion in relation to refusing blood transfusions but I've never came across a Jehovahs witness who didn't want to give blood for a test? He eventually agreed when I explained that I would be only taking a small amount and that it was to help us help his chest pain.... I'm just wondering if anyone has had a similar experience?

oh forgot to mention! I work in a university/student town.... the amount of students we get during exam week is really ridiculous. They come in the morning before their exam with ''abdo pain'' and want to leave almost right after being asessed... but NOT WITHOUT a sick note!

the patients that come in because they forgot to fill their prescription at their GP and its now the weekend... the patients that have had a cough/leg pain/sore whatever for MONTHS and decide that TODAY IS THE DAY that they will come to the emergency department and not bother to see their local GP (in saying that yes i know that there are plenty of people who don't have their own doctors but still) rich ''important'' patients who want a private room, and don't understand why they have to wait.

I am a new grad (also graduated december 2011) and got a job right away in the ER. If we didn't have enough in common.... i only had 6 weeks orientation as well! I was nervous at first.. i thought maybe I would need a longer orientation... but to be honest you learn a LOT in those 6 weeks... by the last week you should be taking your own patient load with your preceptor doing nothing but being there if you absolutely need him/her. I was ready to be on my own at the end of the 6 weeks. I am now in week 3 of being on my own and everyone is EXTREMELY supportive and helpful.... so its not like that extra support just stops at the end of the 6 weeks. You definitely work harder once you're on your own but time flys and i absolutely love it! My advice to you is to make the most out of your orientation. ASK QUESTIONS. Think of scenarios in your head "what would I do if this happened?" remember where things are... if you see another nurse doing something that you haven't done before.. go watch and see how its done... offer to help. If you ever get down time do a round and ask every single nurse if they need a hand with anything. good luck!

I am a newgrad nurse. I've been working in a busy ED for two months now and absolutely love it and I couldn't be happier. Unfortunately this morning I came across a ''situation'' and am not sure if I dealt with it in the right way. This morning I started my shift at 7am. The nurse who I was meant to receive a handover from for 3 patients had went home 10 minutes early (so i ended up getting the handover from another night nurse that only briefly looked after these patients). One of the patients presented at 0230 that morning with severe abdominal pain. From his arrival time up until 0640 he received 15mg morphine IV, 100mg Norflex PO and 50mg oxycontin PO. I noticed that the ONLY set of V/S that the nurse documented was the baseline at 0230 . The nurse also failed to put a name bracelet on the patient, didn't provide the patient with a gown-- nothing was organized. To top it off, the paperwork (assessment sheet) was only 1/2 filled out. I had a look at the patient list for the night to see if it was insanely busy but it wasn't. This particular nurse is a lovely, kind, funny nurse however he is also notorious for being very slack/lazy. I know this because he was my preceptor when I was a student nurse. I ended up going to the ACN to express my concern and show her the lack of documentation. She instructed me to write a note and document exactly what happened and that she would raise the issue with the RN. I did what she said and luckily I didn't have to sign my name at the end. Did I do the right thing? I felt maybe I should have raised this issue with the RN and let him know directly my concerns rather than going straight to management.... but this isn't the first time this RN has done this so maybe not? Could I have just ignored it... would any of you just ignored it and moved on? I also hate to be a complainer since I am still extremely new. I wrote in the ''note'' that i felt the patients safety was comprimised. Do you think that was okay to write? Any advice or tips on how to deal with this situation if it ever arises again would be greatly appreciated. Thank you!